Two hundred to five hundred Gy high dose and dose rate radiation therapy with Synchrotron generated microbeam is curative even for most radiation resistant tumors like glioblastoma multiforme (1). Its dose rate is in the range of 20 Gy/sec. This invention is aimed at very high dose and absorbed dose rate radiosurgery with compact RFQ accelerators and RFQ-drift tube combination accelerators and proton microbeam and nanobeam generation by accelerated proton beam splitting into multiple parallel microbeams and nanobeams for high dose and dose rate radiosurgery and with ion induced nuclear reaction radiotherapy (I-INRRT).
In general, curative surgery removes the entire visible tumor but leaves residual microscopic tumor cells behind that may proliferate and metastasize. Conventional radiation and chemotherapy destroys most of the residual tumor cells. However by the present methods of conventional radiation therapy, the maximum dose that can be administered to a tumor is limited to about 70 to 80 Gy. This dose is delivered by divergent, broad beam fractionated radiation therapy at daily dose of 1.8 to 2 Gy. Its dose rate per second is about 5-10 cGy. It is a relatively lower dose radiation. It does not cause significant oxidative direct and indirect damage to DNA and to proteins, especially to proteins that controls cell cycles and cell proliferation. Tumor cells that acquire radiation resistance are not controlled fractionated, 5-10 cGy per second radiation therapy.
Very high dose chemotherapy that cause DNA and protein damage without severe normal tissue damage is not available. Most tumor cells acquire resistance to conventional radiation and chemotherapy. Tumor stem cells with metastatic potentials are usually resistant to 70 to 80 Gy fractionated 5-10 cGy/sec accelerator dose rate broad beam radiotherapy.
In summary, the present surgery, radiation and chemotherapy are only partially effective to cure and control most tumors. Hence after surgery, tumors with residual radiation and chemotherapy resistant cancer stem cells and cells with metastatic potentials will continue to proliferate even after completion of the present fractionated 70 to 80 Gy radiations and conventional chemotherapy. It culminates in our inability to cure and control most cancers.
The advantages of simultaneous multiple field radiation therapy with super high additive absorbed dose rate at isocenter from multiple simultaneous beams are described by this applicant. They include U.S. Pat. Nos. 7,714,624 (2), 7,835,492 (3) and 7,902,530 (4), none-provisional patent application Ser. Nos. 12/655,825 (5), 12/658,205 (6), 12/459,120 (7), 12/799,949 (8) and 12/929,770 (9). In this invention, the same principles of simultaneous multiple beam radiation therapy is implemented for proton spray radiation therapy. It increases the dose and dose rate of low energy proton beam. It also generates high LET radiation with low energy proton beam by proton beam-beam collision reactions that produce locally absorbed secondary protons, neutrons, α-particles, ions and gamma rays.